What Is Stendra (Avanafil)? How Does This ED Medication Differ From Sildenafil or Tadalafil

Stendra vs. Viagra: Which Is More Effective?

Developed in the 2000s and approved by the FDA in 2012, Stendra® is the newest medication on the market for erectile dysfunction (ED).

Naturally, Stendra is often compared to older medications used to treat ED, such as Viagra®. As a newer medication, Stendra offers a range of advantages over older medications for ED, from a lower risk of causing side effects to its quicker absorption into the body.

Below, we’ve compared Stendra (avanafil) and Viagra (sildenafil) on a variety of factors to help you learn more about which erectile dysfunction treatment is the best match for your needs and expectations.

The Basics: Stendra vs. Viagra

Stendra and Viagra are both medications for treating erectile dysfunction. Both belong to a class of medications called PDE5 inhibitors, which work by increasing blood flow to the erectile tissue inside your penis.

Both medications can be taken before sex. Viagra typically starts working in 30 minutes to one hour, whereas Stendra is a faster-acting medication that can begin working in 15 to 30 minutes.

Although both medications work by increasing blood flow to your penis, Stendra is more selective in its effects. This means that it’s slightly less likely to cause some side effects than Viagra.

Contrary to popular belief, neither Stendra nor Viagra cause random erections or affect your sex drive. Both medications only cause erections when you have a form of sexual stimulation, such as sexual activity or a sexual thought.

As an older medication, Viagra is now available as a generic, making it more affordable than Stendra. The generic name for Viagra is sildenafil. Because Stendra is so new, it’s unlikely that a generic version will be made available in the next few years.

Does Stendra or Viagra Work Faster?

One of the biggest advantages of Stendra is that it works quickly, often in as little as 15 minutes after consumption.

Stendra is available in three doses: 50mg, 100mg and 200mg. The 100mg and 200mg Stendra tablets typically start to work within 15 minutes, meaning you can take them only a few minutes before you plan to have sexual intercourse.

The smaller 50mg dose of Stendra typically starts to work 30 minutes after you take it, meaning it’s also a convenient option for as-needed use before sex.

This makes Stendra the fastest-acting erectile dysfunction treatment currently on the market. If you’re looking for a pill that works quickly — meaning you can take it right before sex — Stendra is currently the best choice available.

Viagra and generic medications containing sildenafil, on the other hand, typically take action in about one hour. This means that you’ll need to take the medication slightly earlier than Stendra for it to be effective by the time you plan to have sex.

This is also the case for Cialis® (tadalafil) and Levitra® (vardenafil), which also require around one hour to take effect within the body.

One additional point in Stendra’s favor is that it can be taken with or without food, without any significant effect on the average amount of time that’s required for it to become effective within your body.

Viagra, on the other hand, may take longer to start working if you take it at the same time as a meal, particularly if the meal has a significant amount of fat.

This means that Stendra might be a more convenient option for you if you’re looking for an ED medication that’s quick to start working and can be taken with dinner.

Which Medication Lasts for Longer?

Stendra has a slightly longer half-life than Viagra, meaning one tablet of it will generally provide relief from erectile dysfunction for longer than an equivalent dose of Viagra.

How long does Stendra last? Avanafil, the active ingredient in Stendra, has a terminal half-life of around five hours, meaning it takes five hours to reach 50 percent of its original concentration in your body.

This means that if you take your prescribed dose of Stendra at 6pm, it will have reached half of its original concentration by approximately 11pm.

A normal dose of Stendra provides relief from erectile dysfunction for around six hours, with its effects typically fading as its concentration declines.

Like with other ED treatments, it’s common for Stendra to become less effective as more time passes since you took the medication. Because of this, it’s best to use Stendra as close to the time you plan to have sex as possible.

Sildenafil, the active ingredient in Viagra, has a half-life of four hours. A typical dose of Viagra or generic sildenafil will generally provide relief from erectile dysfunction for around three to five hours, with its effectiveness waning as its concentration decreases.

The effects of Viagra are usually most noticeable during the first one to two hours after you take the medication.

Both Stendra and Viagra are short-acting ED medications designed for use as needed, such as before you have sex. Neither medication should be taken more than one time per day, meaning they’re best used if you plan to have sex at a specific time (for example, following dinner).

If you like to have sex spontaneously and want a longer-lasting medication for the treatment of erectile dysfunction, you may get better results from Cialis, or generic tadalafil.

Cialis is a long-lasting medication for ED. In fact, it’s often referred to as the “weekend pill” due to its 17.5 hour half-life, which allows a single dose to provide relief from erectile dysfunction for as long as 36 hours.

Since Cialis can be used on a daily basis, it’s an option worth considering if you need an ED pill that’s “always on.”

Does Stendra or Viagra Treat ED Better?

Clinical studies of avanafil (the active ingredient in Stendra) and sildenafil (the active ingredient in Viagra) show that both medications are very effective at treating erectile dysfunction for most men.

Despite being a relatively new medication, Stendra is backed up by several large-scale studies of men with ED.

In a 2012 study published in the journal BJU International, researchers found that avanafil, the active ingredient in Stendra, was “effective and well tolerated” as a treatment option for erectile dysfunction.

In this study, men with ED who received the medication at a dose of 100mg or 200mg showed significant improvements in an International Index of Erectile Function erectile function domain self report (IIEF-EFD), a scoring system used to assess erection quality.

Other studies of Stendra have produced similar findings. In a 2014 clinical review, researchers found that men with erectile dysfunction who used avanafil displayed improvements in erection quality at all dosages, from the lowest 50mg dose to the strongest 200mg tablet.

The researchers also noted that the effectiveness of avanafil increased with dosage, with little increase in side effects.

In short, Stendra is proven to work well as a treatment for erectile dysfunction, with large-scale studies backing up its effectiveness.

As for Viagra, there are countless studies showing its success as a treatment for ED. In a 1998 study, researchers noted that sildenafil, Viagra’s active ingredient, is an “effective, well-tolerated treatment” for men with ED.

Other studies of Viagra have generally produced similar findings. In a clinical review from 2002, researchers stated over 95 percent of men who with ED used sildenafil over one to three years reported feeling satisfied about the effects of the treatment on their erections.

In short, Stendra and Viagra are both highly effective treatments for ED. Although some users might prefer one medication to the other, study data shows that both medications work well for improving erection quality and enhancing sexual performance.

Which Medication Has Fewer Side Effects?

Stendra and Viagra can both cause similar side effects. However, study data shows that fewer men experience several common side effects, such as headaches and nasal congestion, with Stendra than with Viagra.

Headaches are the most common side effect of both medications. According to FDA trial data, 10.5 percent of men who use Stendra at the highest prescribed dose report headaches.

A smaller percentage of men who use Stendra at 50mg and 100mg doses also report dealing with headaches after using the medication.

In contrast, approximately 28 percent of men who take Viagra at the highest prescribed dose report experiencing headaches, making this side effect nearly three times as common among men who use Viagra to treat ED.

This is also a common trend for other side effects. Facial flushing is a common side effect of both Stendra and Viagra. However, it occurs in only 4.3 percent of men who use the highest prescribed dose of Stendra, versus 18 percent of men who use Viagra.

Similarly, side effects such as nasal congestion, heartburn and back pain are all significantly more likely to occur with Viagra than with Stendra.

More severe side effects, such as loss of vision and other vision-related issues, also appear more frequently among men who use Viagra than among Stendra users.

These differences in side effect rates are likely the result of Stendra’s more selective effects in the body. Stendra specifically targets the PDE5 enzyme, meaning it has a lower risk of causing side effects from inhibiting PDE1, PDE6 and other enzymes.

This allows it to more specifically expand the blood vessels that supply the erectile tissue inside the penis, with reduced effects elsewhere in the body.

Stendra and Viagra can both cause a side effect called priapism — a prolonged, painful erection that may last for four hours or longer. Priapism is highly uncommon, but it’s a serious issue that requires urgent medical attention to avoid damaging the tissue inside your penis.

Both Stendra and Viagra have the potential to cause drug interactions when they’re taken with other medications and substances.

Specifically, both medications can interact with nitrates and other blood pressure medications, such as alpha-blockers. When used together, these medications may cause a rapid decline in blood pressure levels that could cause dizziness, fainting or serious cardiovascular events.

To reduce your risk of experiencing interactions while using Stendra or Viagra, it’s important to inform your healthcare provider about any medications you currently use or have recently used before taking either ED treatment.

It’s also important to avoid any recreational drugs that could cause interactions with Stendra or Viagra.

You can learn more about Stendra’s side effects, including the specific risk of each type of side effect and interaction, in our detailed guide to Stendra side effects.

In general, while both medications can and occasionally do cause side effects, Stendra is less likely to cause common side effects and has fewer severe side effects than older ED treatment medications, such as Viagra (sildenafil), Cialis (tadalafil) and Levitra (vardenafil).

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Which Medication is Safer?

Stendra and Viagra are both safe medications, provided they’re used as prescribed. If you’re a healthy male with no history of cardiovascular disease, kidney disease, high blood pressure or other health issues, you can safely use either drug as prescribed by your doctor.

Both medications are sold as prescription drugs only, meaning you’ll need to talk to your doctor before you can use either Stendra or Viagra.

To keep yourself safe, make sure to closely follow your healthcare provider’s instructions and only use Stendra or Viagra as prescribed.

It’s also important to tell your healthcare provider if you currently have any medical conditions that may affect your use of Stendra or Viagra, or if you’ve previously suffered a heart attack or stroke.

What Is Stendra (Avanafil)? How Does This ED Medication Differ From Sildenafil or Tadalafil?

Stendra is the brand name of the latest PDE-5 erectile dysfunction medication on the market. Stendra was released in 2012, and is currently the newest PDE-5 ED medication available.

The PDE-5 medications function very similarly in the body, and work pretty well for most men experiencing erectile dysfunction. However, when diving into the nuances of these medications there are some slight differences that may help you or your doctor find the one that best suits you.

Below, we will look into some of the differences and similarities between Stendra and the two most common generic erectile dysfunction medications (Sildenafil and Tadalafil).

How is Stendra similar to Sildenafil or Tadalafil?

For these three medications, there are a lot of similarities. Below are a few of the most important things that make Stendra, Sildenafil, and Tadalafil alike for patients.

Class of medications:

All three of these medications are in the class of medications called PDE-5 inhibitors.

Mechanism of action:

The way these medications function in the body is also the same. PDE-5 inhibitors relax the smooth muscles in the penis and dilate vessels to improve local blood flow. Ultimately, these medications make it easier for men with ED to achieve and maintain an erection.

Side effects:

The reported side effects of these medications are also very similar. For Stendra, the most commonly reported side effects during clinical trials include headache, flushing, congestion, nasopharyngitis, and back pain.

For Viagra (Brand name of Sildenafil), the most common side effects during clinical trials include headache, flushing, heartburn, abnormal vision, congestion, myalgia, back pain, nausea, dizziness, and rash.

For Cialis (Brand name of Tadalafil), The most commonly reported side effects include headache, heartburn, back pain, myalgia, congestion, flushing, and pain in a limb.

As you can see above, there are many overlaps and commonalities between these three medications, which is what we would expect for medications in the same medicinal class.

Tolerability:

All three medications are normally well-tolerated, and the vast majority of users do not need to stop using these medications due to severe, annoying, or problematic side effects.

How is Stendra different from Sildenafil or Tadalafil?

The small differences between these three medications are truly what set them apart and help doctors and patients choose one which is tailored to their schedule and lifestyle.

Time to start working:

The time that these medications take to start working is probably one of the biggest functional differences between the three.

The Stendra onset of action may be as soon as 15 minutes after taking the tablet.

The Sildenafil onset of action may be 30-60 minutes after taking your dose.

And, the Tadalafil onset of action may be 15-45 minutes after taking your medication.

How long it lasts:

When discussing how long these medications last, it is important to note that this does not mean an erection will last for this long, just that the medication may make it easier for you to achieve and maintain an erection during this window of time after using the medication.

The ideal duration of action may be a personal preference, and some may opt for an ED medication that quickly gets out of your system in a few hours, or one that really sticks around — maybe as long as 3 days.

The duration of action for Sildenafil is about 12 hours.

And, the potential duration of action for Tadalafil is up to 36 hours.

Cost:

If the affordability of medications is an issue, this may also be a big difference to consider between these medications.

Currently, Stendra is a brand-only medication, as a generic version has not yet been released. This means that the cost per tablet is much more expensive than a generic Sildenafil or generic Tadalafil tablet.

Both Sildenafil and Tadalafil are generic medications. Sildenafil is the generic version of the brand name medication, Viagra. And Tadalafil is the generic version of the brand name medication, Cialis. If you do decide that you want to stick with the brand-name medications, you will likely also encounter a higher price tag, although most users opt for the generic versions due to the significant cost savings.

Currently, in October 2021, the cash price for 6 Stendra tablets comes up to around $400.

This is compared to the generic Sildenafil or Tadalafil tablets which you can find at Strut Health for as low as $3 per dose.

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Here at Strut Health, we try to make getting high-quality medical treatment for potentially sensitive situations easier for you. We also pride ourselves in having some of the most competitive and affordable prices available.

We offer Sildenafil (generic Viagra) and Tadalafil (generic Cialis) medications for men who are suffering from ED symptoms.

If you are interested in seeing if Sildenafil or Tadalafil are a good fit for you, you can have a free online questionnaire-based telemedicine consultation with our U.S. licensed doctors today in about 10-15 minutes.

If you are a good candidate for ED treatment, your medication can be shipped to your front door with our free shipping.

If you have any questions or concerns during your treatment, our team and doctors are available for free unlimited follow-ups.

Erectile dysfunction drugs vary in effectiveness, side effects

(Reuters Health) – Viagra is the most effective treatment for erectile dysfunction, but it also has a higher rate of side effects than other options, according to an analysis of more than 150 trials.

Viagra is known generically as sildenafil. Men concerned about possible side effects of Viagra like headaches, flushing, indigestion and nasal congestion may want to start on Cialis, which is known generically as tadalafil, researchers report in European Urology. If that’s not effective, men in some countries can try Zydena (udenafil).

Many men have trouble getting or keeping an erection, especially as they age, but erectile dysfunction – also known as ED – is not a natural part of aging, according to the U.S. National Institutes of Health.

The new review compares seven common ED therapies, all belonging to a class of medications called phosphodiesterase 5 inhibitors (PDE5i’s). They work by inhibiting an enzyme that may reduce the potency of an erection.

Viagra, Cialis, Levitra (vardenafil) and Stendra (avanafil) all work this way and are approved for use in the U.S. The additional drugs Zydena, Helleva (lodenafil) and Mvix (mirodenafil) are only approved for use in other countries.

PDE5i’s are considered the first-choice therapy for ED, but they’re only effective for 60 to 80 percent of men who try them, and many will stop taking them, according to Dr. Alexander W. Pastuszak of Baylor College of Medicine’s urology department in Houston, Texas. He was not part of the new study.

Researchers at the University of Zurich, the Swiss Federal Institute of Technology, and Maastricht University Medical Center in the Netherlands reviewed 82 studies of the drugs’ effectiveness and 72 studies exploring side effects.

These treatments are all more effective than placebo for treating erectile dysfunction, and are generally safe and well tolerated, the authors note.

A 50- or 100-milligram (mg) dose of Viagra appeared to be the most effective treatment. It performed about 50 percent better than a placebo. Smaller doses were less effective. Stendra, in doses ranging from 50 to 200 mg, was among the least effective – only 20 to 30 percent more effective than a placebo.

The 50-milligram dose of Stendra was associated with the lowest rate of side effects of any medication – 8.5 percent of the time. A 20-mg dose of Levitra had the highest rate of side effects: 25 percent. Higher doses of Viagra and Cialis tended to cause side effects between 21 and 22 percent of the time.

“Viagra has an established efficacy and safety profile and remains an important treatment option for men with erectile dysfunction,” a spokesperson for Pfizer, makers of the drug, told Reuters Health in a statement. “Viagra has been studied for more than 15 years in more than 136 completed and ongoing clinical trials involving more than 23,000 men with ED.”

Side effects depend on which drug is used and what other enzymes the drug is able to inhibit, Pastuszak told Reuters Health by email. One of the main side effects of Viagra is visual changes, whereas Cialis more often causes muscle pain.

More generally, these types of ED drugs can cause a drop in blood pressure, because they are vasodilators, which open blood vessels, he said. He added that they should not be used with nitrate-based heart medications since they can cause a steep drop in blood pressure.

“Other common side effects include facial flushing, congestion, headache, and upset stomach,” Pastuszak said.

“Men complain of side effects, but more often of a lack of complete efficacy,” he said. “The drugs are not for everyone, as they won’t necessarily help a man with severe erectile dysfunction as much as they would someone with mild or moderate ED.”

Urologists will already have an understanding of the effectiveness and side effects of the available ED therapies, so the new results will not be a surprise, he said.

Only Cialis is to be taken daily, the other options are all short-acting, so men have the option of trying several to see which one works well, he said.

Doctors should carefully discuss expectations and treatment effects of the various options with patients before choosing a therapy, the authors write. Some ED patients may want immediate stronger efficacy at the cost of higher side effects, while others may not.

Stendra vs. Viagra: Differences, similarities, and which is better for you

If you suffer from erectile dysfunction (ED), you are not alone. An estimated 15 to 30 million men in the United States experience ED. Stendra (avanafil) and Viagra (sildenafil) are two medications used in the treatment of ED. They belong to a group of FDA-approved prescription medications called phosphodiesterase-5 inhibitors (PDE5 inhibitors). Other drugs in this class of ED medications include Cialis (tadalafil) and Levitra (vardenafil).

PDE5 inhibitors work by increasing both the levels and activity of nitric oxide. By doing this, there is better blood flow to the penis, causing an erection. The medications also help to prolong erections and increase sexual satisfaction. It is important to note that PDE5 inhibitors work in conjunction with sexual stimulation.

What are the main differences between Stendra and Viagra?

Stendra and Viagra are both PDE5 inhibitors used in the treatment of erectile dysfunction.

Stendra is currently only available in a brand name only. The chemical name is avanafil, but the drug is not yet available as avanafil, only as brand-name Stendra.

Stendra should be taken as a 100 mg or 200 mg dose, as early as 15 minutes prior to sexual activity. It can also be dosed at 50 mg approximately 30 minutes before sexual activity.

Viagra should be taken approximately one hour prior to sexual activity. Whether you take Stendra or Viagra, only one dose should be taken in one day.

Regardless of the drug or dose, the medication should be accompanied by sexual stimulation in order to be effective. Either drug may be taken with or without food.

Main differences between Stendra and Viagra
Stendra	Viagra
Drug class	PDE5 inhibitor	PDE5 inhibitor
Brand/generic status	Brand	Brand and generic
What is the generic name?	Avanafil (but it is not yet available in generic)	Sildenafil
What form does the drug come in?	Tablet (50 mg, 100 mg, 200 mg)	Tablet (25 mg, 50 mg, 100 mg)
What is the standard dosage?	Example: one 100 mg tablet 15 minutes before sexual activity OR one 50 mg tablet approximately 30 minutes before sexual activity *not to be taken more than once in a day	Example: one 50 mg tablet one hour prior to sexual activity but can range anywhere from 25 mg to 100 mg taken 30 minutes to 4 hours before sexual activity *not to be taken more than once in a day
How long is the typical treatment?	As needed	As needed
Who typically uses the medication?	Adult males	Adult males

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Conditions treated by Stendra and Viagra

Both Stendra and Viagra (What is Viagra?) have only one official indication—the treatment of ED in men. However, both drugs may be used off-label for Raynaud’s phenomenon. Viagra is sometimes used off-label to treat female sexual arousal disorder.

Condition	Stendra	Viagra
Erectile dysfunction	Yes	Yes
Raynaud’s phenomenon	Off-label	Off-label
Female sexual arousal disorder	No	Off-label
Treatment of pulmonary arterial hypertension (WHO Group I) in adults to improve exercise ability and delay clinical worsening	No	Yes, but not as Viagra. Only when prescribed as Revatio (or its generic sildenafil), in doses of 20 mg three times daily

Is Stendra or Viagra more effective?

A review of clinical studies concluded that Stendra was comparable in efficacy to Viagra, as well as other PDE5 inhibitors. The study also noted that Stendra is more favorable in terms of side effects and drug interactions, and has less of an effect on lowering blood pressure.

Another review of studies concluded that Stendra is safe and effective, but speculated an uncertainty for Stendra’s place in the market. This is because all PDE5 inhibitors are similar, and besides Stendra, all of them are available in generic, offering a significant money-saving advantage to the patient. The authors predicted that, “a new agent without such a long history may have difficulty finding a market share.”

The most effective medication for you should only be determined by your doctor, who can look at your medical condition(s), history, and other medications you take.

Coverage and cost comparison of Stendra vs. Viagra

There is a wide variation in regards to insurance coverage for Stendra or Viagra. Some insurance companies pay for them, and others do not. Some insurances have a limit on the quantity that you can fill, for example, your insurance may allow four tablets per month on an ED medication.

A standard prescription of #10 tablets of Stendra 100 mg (available in brand-name only) will cost about $680 with a SingleCare discount card.

A standard prescription of #10 tablets of sildenafil 50 mg (generic Viagra) tablets can range from $150-$300 depending on which pharmacy you use.

Stendra	Viagra
Typically covered by insurance?	Coverage varies	Coverage varies
Typically covered by Medicare Part D?	No	No
Standard dosage	#10 tablets, 100 mg	#10 tablets, 50 mg
Typical Medicare copay	Varies (patients often pay out of pocket)	Varies (patients often pay out of pocket)
SingleCare cost	$680	$150+

Common side effects of Stendra vs. Viagra

Stendra and Viagra have many similar side effects, however, it is important to note that the frequency varies by dose. For example, 16% of patients taking Viagra 25 mg experienced headaches, but with a dose of 100 mg, 28% of patients experienced headaches.

With Stendra, the most common side effects are headache, flushing, nasal congestion, and back pain. The most common side effects of Viagra are headache, flushing, nasal congestion, and indigestion.

This is not a complete list of side effects. Consult your healthcare provider for a full list.

Stendra		Viagra
Side Effect	Applicable?	Frequency	Applicable?	Frequency
Headache	Yes	5.1-10.5%	Yes	16-28%
Flushing	Yes	3.2-4.3%	Yes	10-19%
Nasal congestion	Yes	1.8-2.9%	Yes	4-9%
Back pain	Yes	1.1-3.2%	Yes	3-4%
Indigestion	Yes	1-2%	Yes	3-17%
Dizziness	Yes	1-2%	Yes	3-4%
Nausea	Yes	1-2%	Yes	2-3%

Drug interactions of Stendra and Viagra

Patients taking Stendra or Viagra should never take nitrate medications, such as nitroglycerin. The combination is contraindicated (should never be used together) because it could result in dangerously low blood pressure.

There are many drugs that, in combination with Stendra or Viagra, could cause blood pressure to decrease. These include alpha blockers (such as alfuzosin, terazosin, or tamsulosin), riociguat (a drug used to treat pulmonary arterial hypertension), and blood pressure medications. These drugs should only be used with Stendra or Viagra with caution, and with appropriate monitoring by your healthcare provider.

Drugs are metabolized with the help of enzymes, and a common one is the cytochrome P450 3A4 (CYP3A4) system. A drug that inhibits CYP3A4 can cause another drug to build up in the system, by inhibiting, or slowing down, how the other drug is processed. For example, if drug A inhibits drug B, you will get a buildup of drug B in your body, which could lead to increased side effects. Drugs can be strong inhibitors or moderate inhibitors.

Patients taking a strong 3A4 inhibitor should not take Stendra, and patients taking a moderate inhibitor should take no more than 50 mg, and only if approved by the doctor. Viagra should be started at the lowest dose of 25 mg when given with a strong 3A4 inhibitor. If taken with the protease inhibitor ritonavir, Viagra should be taken as 25 mg at least 48 hours apart.

Other drug interactions may occur; consult your healthcare professional for a full list of drug interactions.

Drug	Drug Class	Stendra	Viagra
Nitroglycerin	Nitrates	Yes	Yes
Riociguat	Guanylate cyclase stimulator	Yes	Yes
Alfuzosin Tamsulosin Terazosin	Alpha blockers	Yes	Yes
Lisinopril Amlodipine Bystolic Metoprolol Losartan Ramipril etc.	Antihypertensives	Yes	Yes
Ketoconazole Itraconazole, Clarithromycin Ritonavir Saquinavir Nelfinavir Indinavir Atazanavir	Strong CYP 3A4 inhibitors	Yes	Yes
Erythromycin Aprepitant Diltiazem Fluconazole Fosamprenavir Verapamil	Moderate CYP 3A4 inhibitors	Yes	Yes

Warnings of Stendra and Viagra

Cardiovascular health should be assessed before you take Stendra or Viagra. Certain patients may not be a candidate for Stendra or Viagra. Ask your doctor before taking Stendra or Viagra, if you have any problems with your heart or blood pressure.
Currently, it is recommended that Stendra or Viagra is not used in patients with recent cardiac events, such as a heart attack or stroke, patients with resting low blood pressure (less than 90/50 mmHg) or high blood pressure (more than 170/100 mmHg), and patients with unstable angina. Consult your doctor if you have heart or blood pressure problems.
Stendra or Viagra should not be used in patients who take nitrates such as nitroglycerin, or a guanylate cyclase stimulator such as riociguat, due to increased effects on lowering the blood pressure. Other medications in combination with Stendra or Viagra can affect blood pressure as well (see drug interaction chart).
Use Stendra or Viagra with caution in patients with anatomical deformation of the penis.
Occasionally, a prolonged erection (more than 4 hours), or priapism (a painful erection lasting longer than 6 hours) may occur. If an erection lasts longer than 4 hours, seek immediate medical attention. Failure to treat this condition immediately could result in permanent damage.
If you experience a sudden loss of vision or a sudden loss of hearing (which may be accompanied by dizziness or ringing in the ears), stop Stendra or Viagra and seek immediate medical attention.
Avoid substantial amounts of alcohol with Stendra or Viagra, because the combination could lead to an increased heart rate, lower blood pressure, dizziness, and headache.
Stendra or Viagra do not protect against sexually transmitted diseases, so other protective measures, such as condoms, should be used.
Because Stendra and Viagra are not indicated for women, there is no clinical data about the safety of these drugs in pregnancy. Therefore, it is not recommended to use Stendra or Viagra in pregnancy.

Frequently asked questions about Stendra vs. Viagra

What is Stendra?

Stendra (avanafil) is a PDE5 inhibitor that treats erectile dysfunction in men. Along with sexual stimulation, it helps increase blood flow to the penis, helping the patient achieve and maintain an erection. Currently, it is only available in brand name; there is no generic available yet.

What is Viagra?

Viagra (sildenafil) is a PDE5 inhibitor used to treat erectile dysfunction in men. It increases blood flow to the penis (in conjunction with sexual stimulation) so you can achieve and maintain an erection. Viagra is available in brand and generic.

You may have heard of a drug called Revatio used for ED, instead of Viagra. Revatio is another drug that contains sildenafil, the same ingredient in Viagra. Revatio is used to treat pulmonary arterial hypertension (PAH). Although Revatio is indicated only for PAH, it is often prescribed off-label for ED. Sometimes, when an insurance company does not cover Viagra, a doctor may prescribe Revatio instead, which is usually covered by insurance.

Are Stendra and Viagra the same?

Not exactly. They are very similar and are in the same category of drugs—PDE5 inhibitors. However, they do have some differences, outlined above.

Is Stendra or Viagra better? / Is Stendra more effective than Viagra?

Looking at trials, both drugs are very similar in efficacy, and both drugs are well-tolerated. One study noted that Stendra may have difficulty finding a place in the market due to its availability only as brand-name, with a much higher price than other PDE5 inhibitors. Viagra seems to be much more popular, but likely due to its lower price and time on the market. It may sometimes take trial and error to find the medication that is best for you, and your doctor can help you decide.

Can I use Stendra or Viagra while pregnant?

Because neither drug is indicated for use in women, there are no studies to determine safety in pregnancy. Therefore, it is not recommended to use Stendra or Viagra while pregnant.

Can I use Stendra or Viagra with alcohol?

Alcohol can interfere with the body’s ability to achieve an erection; however, it might be okay in small quantities. Ask your medical provider for advice.

How long does Stendra last for?

Stendra begins to work as soon as 15-30 minutes after the medication is taken, and can last for up to six hours.

Is there a generic for Stendra?

Currently, there is no generic for Stendra. When there is a generic available, it will be called by its chemical name, avanafil.

Can you buy Stendra over the counter?

No. Stendra is only available by prescription in the United States. Viagra is also only available by prescription in the US.